Prescription medication cost-related non-adherence among Medicare CAHPS respondents: disparity by Hispanic ethnicity.

Purpose: We examined whether there was disparity in prescription medication cost-related non-adherence (CRN) by Hispanic ethnicity among Medicare enrollees.

Methods: Multivariate logistic regression, adjusting for race, other socio-demographic variables, health status, health care utilization, and patient rating of their personal physician, was used to examine association of Hispanic ethnicity with CRN using cross-sectional data from Medicare's Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey (data collected in Spring 2007).

Results: Hispanic respondents constituted 6.

The development of a CAHPS instrument for Nursing Home Residents (NHCAHPS).

We report on a federal initiative to develop a CAHPS (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of-life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best.

Evaluating the effect of translation on Spanish speakers' ratings of Medicare.

This study examined the equivalence of the English and Spanish versions of the Medicare Consumer Assessment of Health Plans Study (CAHPS) fee-for-service (FFS) survey among 2,996 Hispanic Medicare beneficiaries. Multigroup confirmatory factor analyses indicated that with few exceptions the factor structures were very similar for the English and Spanish surveys. However, item response theory-based methods for investigating differential item functioning (DIF) revealed that several items demonstrated threshold-related DIF, suggesting that respondents in the two languages utilized the response options for the items differently.

Are older patients satisfied with physician assistants and nurse practitioners?

Objective: To determine how satisfied older American consumers are with physician assistant (PA) and nurse practitioner (NP) care.

Design: Cross-sectional national survey.

Setting: Noninstitutional, representative random sample of people aged 65 years and older.

Variation in racial and ethnic differences in consumer assessments of health care.

Background: Prior studies have documented significant racial and ethnic disparities in health and healthcare, but data about disparities from consumer assessments of care are inconsistent.

Objective: To examine racial/ethnic differences in consumer assessments and explore variation in such differences across health plans.

Methods: Data included 160694 Consumer Assessment of Health Plans Surveys (CAHPS) responses from 307 commercial health plans and 177 489 Medicare beneficiaries in 308 Medicare+Choice managed care plans collected in 1999.